Arthritis

Arthritis is an inflammation of the joints, surrounding
tendons, ligaments and cartilage. It can affect virtually every
joint of the body from the feet, to the knees, back, shoulders, and
fingers. The term Arthritis describes a variety of arthritic
conditions, with the three most common forms being Osteoarthritis,
Rheumatoid Arthritis and Gout.
 

Symptoms will vary depending on the type of Arthritis, and
include slight pain, stiffness and swelling of the joints, through
to extreme disability and joint deformity. 

For more information refer to the topics on specific types of
Arthritis. The three types of arthritis include:

Osteoarthritis is a degenerative joint disease and is the most
common form of Arthritis. This joint degeneration results in pain,
deformity and a reduced range of motion. There is generally no
inflammation.
 

Rheumatoid Arthritis

Rheumatoid Arthritis is a chronic inflammatory type of
Arthritis in which joints are equally red, swollen and tender on
both sides of the body. Rheumatoid Arthritis is an autoimmune
disease and typically affects the hands, feet, wrists, ankles and
knees. This type of Arthritis may cause destruction and
disfiguration of the affected joints. 
 

Gout

Gout is an arthritic condition of the body connected with an
excess of uric acid in the blood. It causes the joints to become
red, swollen and painful. The most common area on the body for Gout
to occur is the joint of the big toe. Gout is not a single disease
but is a syndrome resulting from high levels of uric acid in the
blood.
 

The treatment of Arthritis depends on the type of Arthritis.
There are various causative factors associated with Arthritis which
need to be identified. For detailed information and treatment refer
to the topic on the specific type of Arthritis.
 

• The diet generally should be rich in fish oil e.g., salmon,
  tuna, mackerel and mullet. Fish oils may help to regulate the
  inflammatory process.
• It is recommended to include vitamin C rich foods in the diet
  e.g., apples, pears, berries, pawpaw and green vegetables. Vitamin
  C plays a role in the formation and maintenance of connective
  tissue and collagen, which provides stability and strength to
  joints.
• Foods rich in silicon may be beneficial for people with
  Arthritis. These include wholegrain cereals, nuts and
  apple. 
• Weight control is important. This will help minimise the load
  on inflamed joints. 
• Certain food groups such as the “nightshade” vegetables
  (potato, tomato, eggplant, chilli and capsicum) and salicylate-rich
  foods (see examples in the Hives and Hyperactivity Diet topic) may
  aggravate Arthritis.
• Avoid acid forming foods such as red meat and sugar.
• People with Gout should avoid foods high in purines. These
  include liver, kidney, heart, brains, pate, sardines, herrings,
  anchovies, mackerel, yeast and yeast products, beer, asparagus and
  yeast products.

Nutritional supplements are only to be used if the dietary
vitamin intake is inadequate.

• Glucosamine and Mucopolysaccharides can be taken to aid
  connective tissue support. 
• Devil’s claw, feverfew, celery and white willow bark have been
  traditionally used to relieve pain and inflammation associated with
  Arthritis.
• Bromelain, an anti-inflammatory enzyme derived from pineapple,
  may provide symptomatic relief.
• Vitamin C with bioflavonoids are believed to have a positive
  effect on cartilage degeneration.
• Omega-3 fatty acids are thought to be anti-inflammatory.
• Zinc is believed to support the immune system and help reduce
  inflammation.

See the Arthritis Foundation of Australia topic on the
Healthpoint.
 

Ask your Pharmacist for advice.

1. Your Pharmacist can assist with some anti-inflammatory pain
   relief tablets. It is important to ask your Pharmacist to recommend
   the most suitable pain reliever for the type of Arthritis.
2. Remember to exercise according to the advice of your Doctor or
   Physiotherapist. A range of special exercises, such as daily
   stretching, might be suggested to help improve circulation and
   flexibility. 
3. Avoid activities which place a heavy amount of stress on the
   joints.
4. Some relief for Arthritis may be obtained from applying heat if
   the joints are stiff or a cold pack if the joints are warm and
   swollen. Massage, relaxation, exercise, liniments and joint wraps
   may also help to relieve the symptoms of the disease. Some creams
   may give relief. Ask your Pharmacist for advice. 
5. Some nutritional supplements may be considered if the diet is
   inadequate. See individual topics.
6. Your Pharmacist may suggest a suitable pain relief medication.
   Non-steroidal anti-inflammatory drugs or NSAIDsmay also be
   suggested. Take these only after advice from your Pharmacist as
   there are possible side effects.

Rheumatoid arthritis is a condition that causes pain, swelling
and inflammation in the joints.
 

Rheumatoid arthritis is an autoimmune disease. This means that
the immune system, which usually fights infection, attacks the
lining of the joints, causing them to become inflamed. Over time
these joints may become permanently damaged and stop working
properly.

 

The symptoms of Rheumatoid Arthritis tend to develop
gradually. The small joints, such as in the fingers and toes are
often affected first. It can then spread to other joints e.g in the
shoulders, elbows, hips and jaw. The condition tends to affect
several joints at the same time, usually on both sides of the body
e.g it often affects both knees or both hands.
 

Symptoms are often more painful in the morning and begin to
ease as the day progresses. The most common symptoms of Rheumatoid
Arthritis include:

• Swelling, pain and heat in the joints
• Stiffness in the joints, especially in the morning
• Persistent fatigue
• Sleeping difficulties because of the pain
• Weak muscles
• Joints on both sides of the body are usually affected.
• Loss of appetite.
• Generally feeling unwell.
• Skin nodules – one in four people with Rheumatoid Arthritis
  develop painless lumps under the skin over the elbows and forearms,
  known as rheumatoid nodules.
• Anaemia – eight out of ten people with rheumatoid arthritis are
  anaemic.

Flare ups

The symptoms of Rheumatoid Arthritis often tend to come and go
and ‘flare ups’ can occur. This means that from time to time, the
condition will worsen and the symptoms will be more intense and
severe. Although Rheumatoid Arthritis can be frustrating,
particularly during a flare-up, most people are able to carry on as
normal, with some lifestyle adjustments.
 

As with all medical conditions it is advisable to consult your
Doctor for an accurate diagnosis and treatment. There is no cure
for Rheumatoid arthritis but there are many medicines and therapies
that can greatly improve your symptoms. If your GP suspects you
have Rheumatoid arthritis, you will be referred to a specialist
rheumatologist. This is so the diagnosis can be confirmed and the
most appropriate treatment started as soon as possible.

 

Medication

Many different medicines are used to treat rheumatoid
arthritis. Some aim to relieve symptoms and others help to slow the
progression of the condition. Some of the different medicines that
you may be prescribed are outlined below. 

• Analgesics – more commonly known as painkillers e.g
  paracetamol, codeine etc. 
• Non-steroidal anti-inflammatory drugs (NSAIDs) – help to
  relieve pain and stiffness while also reducing inflammation. Some
  of the most commonly used include ibuprofen and aspirin.
• Disease-modifying anti-rheumatic drugs (DMARDs) – are a type of
  medicine that help to ease symptoms and slow down the progression
  of the disease. Early treatment with DMARDs leads to a better
  outcome for the patient.
• Corticosteroids – are a type of medicine that help to reduce
  pain, stiffness and swelling. These are usually used when NSAIDs
  fail to provide relief. They are commonly prescribed on a short
  term basis, often during a flare-up. The long-term use of
  corticosteroids can have serious side effects.

Surgery

Surgery may be required if your Rheumatoid arthritis is
particularly severe. The most commonly replaced joints are hips and
knees. Osteotomy is another type of surgery that helps to realign
joints. You may also need surgery on your hands, to repair damaged
tendons

 

Lifestyle

Staying active is very important as exercise helps to maintain
mobility and prevent the muscles around joints from becoming weak.
Swimming is an ideal type of exercise as the water supports your
weight, taking pressure away from your joints.

 

A physiotherapist will be able to devise an appropriate
exercise plan for you. An occupational therapist can also advise
you on ways to adapt your lifestyle to give you more independence,
confidence and control.
 

General dietary recommendations for a person with arthritis
include:

• Eat a well-balanced diet. 
• Avoid fad diets or fasting. 
• Increase dietary calcium to reduce the risk of osteoporosis in
  later life. 
• Drink plenty of non-alcoholic fluids. 
• Keep your weight within the normal range, by reducing the
  amount of dietary fats you consume.

Fish oils that contain omega-3 fatty acids have been found to
help reduce the inflammation associated with some forms of
arthritis, such as rheumatoid arthritis. Foods rich in omega-3
fatty acids include: 

• Oily fish (such as salmon and sardines) 
• Linseeds and linseed (flaxseed) oil 
• Canola (rapeseed) oil 
• Walnuts

See the topic Rheumatoid Arthritis – Supplements.
 

See the Arthritis Foundation of Australia topic on the
Healthpoint.

Ask your Pharmacist for advice.

1. Ask your Pharmacist about anti-inflammatory pain relief
   medication. It is important to ask your Pharmacist to recommend the
   most suitable pain reliever.
2. Remember to exercise according to the advice of your Doctor or
   Physiotherapist. 
3. Avoid activities that place a heavy amount of stress on the
   joints.
4. Some relief for Rheumatoid Arthritis may be obtained from
   applying heat if the joints are inflamed. Massage, relaxation,
   exercise, liniments and joint wraps may also help to relieve the
   symptoms of the disease. Some creams may give some relief. Ask your
   Pharmacist for advice. 
5. Some nutritional supplements may be considered if the diet is
   inadequate e.g glucosamine sulphate, chondroitin and fish oil